Patients across the areas we visited told us they were treated with dignity and respect. Within ophthalmology we saw excellent joint working with patient groups to improve the delivery of care. Patients told us they were provided with the information they needed to understand the care and treatment options available to them.

Patients experienced effective, safe and appropriate care and treatment. Care was tailored around patient’s individual needs and arrangements were in place for managing foreseeable emergencies. However, patients felt that waiting times within the ophthalmology clinics were problematic.

We found suitable arrangements were in place to pass patient information between the hospital and other providers of care. In addition, information was being transferred internally between outpatients and day surgery effectively. Target timescales for both referral to treatment for ophthalmology and waiting times for day surgery were being adhered to. Discharge from day surgery was taking place effectively and follow up information passed to patient’s GPs and also the district nursing team if required.

Staff received appropriate support, supervision and training to ensure they could provide effective care, treatment and support to patients within their departments. Staff were encouraged to develop their skills further and access additional training and development opportunities. Clinical audits were being undertaken to evaluate and improve the quality of care being provided.

Patients were protected against the risks of unsafe or inappropriate care and treatment because accurate records were maintained. Trust audits within ophthalmology had identified further improvements in record keeping could be achieved. Patient and staff records were held securely and patient confidentiality was maintained.

Our rating of services stayed the same. We rated it them as outstanding because:

• Safe, effective and responsive were rated as good.
• Caring and well led were rated as outstanding however it should be noted that we did not inspect the outpatients service at this inspection and the outstanding ratings were awarded at the previous inspection in August 2015.
• The surgery services were rated as good in all domains.
• Marshalls Cross Medical Practice required improvement in safe, effective and well led but were rated good in caring and responsive.